May 2019

CAQH CORE Releases Phase V Operating Rules

New rules aim to improve prior authorization process

May 2019

Today, 88 percent of prior authorizations are conducted either partially or entirely manually. CAQH CORE has released the Phase V Operating Rules to strengthen the accuracy and trustworthiness of the prior authorization process and move the industry toward full automation.

Call for Data Contribution: The 2019 CAQH Index

Be part of the leading industry source for tracking health plan and provider adoption of fully electronic administrative transactions.

May 2019

Recently, the 2018 CAQH Index study revealed that the healthcare industry could save $12.4 billion by transitioning from manual to electronic processes. These critical findings are made possible by voluntary participation from providers and health plans who help to offer a comprehensive view of common business processes across the industry.

5 Opportunities to Fix Attachments

CAQH CORE releases new white paper

May 2019

The healthcare industry has made significant progress in adopting electronic transactions for common business practices. However, the lack of a standard for attachments has contributed to cumbersome processes for exchanging patient-specific medical information and supplemental documentation.

Easing Access to Provider Directory Data

Integrated portal creates seamless transition between two CAQH Solutions

May 2019

CAQH continues to make progress in improving provider directory data. Most recently, CAQH launched a new portal that streamlines access to provider directory data by integrating DirectAssure and CAQH ProView.

Participation in CAQH ProView for Groups Continues to Grow

May 2019

Late last year, CAQH launched CAQH ProView for Groups to simplify the way data is shared between delegated provider groups and health plans. This first-of-its-kind functionality replaces the highly manual processes widely used today with an intuitive, efficient module within CAQH ProView.